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[KATHMANDU] Nepal needs a better surveillance system to accurately estimate animal-borne parasitic infections that claim more victims than malaria and are comparable to HIV/AIDS in this country, says an international study.

A team of scientists from Belgium, Nepal, New Zealand, Switzerland and the Netherlands estimates the public health burden of animal-borne parasitic disease or 'parasitic zoonoses’ in Nepal at 24,000 healthy years lost annually. 
The study, published in PLOS Neglected Tropical Diseases in January, says that parasitic zoonoses are grouped under neglected tropical diseases (NTDs) that are prevalent in, and often endemic to, low-income countries.

In Nepal, top parasitic zoonoses include 'neurocysticercosis,’ caused by the pork tapeworm that affects the nervous system, and 'cystic echinococcosis,’ caused by dog tapeworms and spread through dog faeces.

A third is 'congenital toxoplasmosis' in which mothers infected with the toxoplasma parasite give birth to infected children.  

The study calculates the burden of these diseases using the global health metric system of disability-adjusted life years (DALYs), which indicates the number of healthy years lost by a patient or a population due to infection, death or both.

The team estimates that Nepal loses 14,268 healthy years annually due to neurocysticercosis, 9,255 years due to congenital toxoplasmosis, and 251 due to cystic echinococcosis.

Nepal's integrated NTD control programme (2010—2014), implemented by the health ministry's epidemiology and disease control division, is hampered by a lack of population-level data for these diseases, says Keshab Yogi, programme officer for NTDs at the WHO office in Nepal.

The study notes that “the official passive surveillance system of the government of Nepal, the Health Management Information system, has been reported to suffer from inconsistencies…active surveillance systems are in place, but (they) only target certain vaccine-preventable diseases, and not parasitic zoonoses.”  

The study analysed numerous data sources to examine the relevance and importance of such infections in Nepal. “We believe that such efforts can help interrupt the vicious circle of under-recognition, underfunding and neglect,” Brecht Devleesschauwer, lead author of the study, told SciDev.Net.

The DALY metric was used in the Global Burden of Disease Report 2010 (a comprehensive regional and global assessment of mortality and disability from major diseases, injuries, and risk factors) to estimate the burden of some parasitic zoonoses in Nepal. “But these merely stratify global estimates by country,” Devleesschauwer said.

“Our paper is a response to such estimates, as our estimates are rooted in local data, and not the result of a multi-country modelling and smoothening exercise,” Devleesschauwer explains.

Link to paper in PLoS Neglected Tropical Diseases

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